Abstract
We report a rare complication of the migration of a feeding jejunostomy tube inside the gut. A Stamm type jejunostomy was performed in a patient with an unresectable esophageal cancer using a 16-F ryles tube, at another center. Two months later, she presented because of the “disappearance” of the tube. A clinical examination revealed a mature jejunostomy tract, skin erosion at the site where the suture was placed, and absence of the tube. There were no signs of intestinal obstruction or peritonitis. Plain abdominal X-ray examination showed the tube inside the abdomen.
The patient was treated initially conservatively with serial radiographs which showed no migration of tube for 4 days. Therefore, an exploratory laprotomy was done with removal of old tube with new feeding jejunostomy at previous entrostomy site.
An awareness of this complication and its appropriate treatment is important given the widespread use of feeding jejunostomy tube.
Keywords: Ryles tube, Feeding jejunostomy, Enteral nutrition, Complications, Migration.
References
- Yagi M, Hashimoto T, Nezuka H, Ito H, Tani T, Shimizu K, et al. Complications associated with enteral nutrition using catheter jejunostomy after esophagectomy. Surg Today 1999;29:214–8.
- Tapia J, Murguia R, Garcia G, de los Monteros PE, Onate E. Jejunostomy: techniques, indications, and complications. World J Surg 1999;23:596–602.
- Haws EB, Sieber WK, Kiesewetter WB. Complications of tube gastrostomy in infants and children. 15-year review associated of 240 cases. Ann Surg 1966;164:284–90.
- O’Dell KB, Gordon RS, Becker LB. Gastrostomy tube transmigration: a rare cause of small bowel obstruction. Ann Emerg Med 1991;20:817–9.
- Goldman DE, Grier JF. The migrating gastrostomy tube. Gastrointest Endosc 1995;42:102–3.
- Konda J, Ruggle P. Prolapse of Foley catheter gastrostomy tube causing obstructive jaundice. Am J Gastroenterol 1981;76:353–5.
- Gowen GF. The management of complications of Foley feeding gastrostomies. Am Surg 1988;54:582–5.
- Pereira MC, Mersich K. Foley catheter gastrostomy tube migration: small bowel obstruction relieved by percutaneous balloon aspiration. Gastrointest Endosc 1991;37:372–4.
- Prahlow JA, Barnard JJ. Jejunostomy tube failure: malnutrition caused by intraluminal antegrade jejunostomy tube migration. Arch Phys Med Rehabil 1998;79:453–5.
- Opeskin K, Lee KA. Failure of a feeding jejunostomy. Med Sci Law 1993;33:263–6.
- Jain BK, Mehta RB. Enteral migration of a Foley catheter after jejunostomy. Can J Surg 1991;34:106–7.
- Kadakia SC, Cassady M, Shaffer RT. Comparison of Foley catheter as a replacement gastrostomy tube with commercial replacement gastrostomy tube: a prospective randomised study. Gastrointest Endosc 1994;40:188–93.
Corresponding Author
Mahesh Kumar Sonwal
Senior Resident, Department General Surgery Government Medical College, Kota
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Contact No: 9785332419
DOI: https://dx.doi.org/10.18535/jmscr/v6i10.22
